If you're in Original Medicare, doctors, and suppliers are required by law to file Medicare claims for covered services and supplies you get. Find out which doctors in your area accept assignment.
If you have a Medicare Advantage Plan (Part C), these plans don’t have to file claims because Medicare pays these private insurance companies a set amount each month.
When do I need to file a claim?
You should only need to file a claim in very rare cases.
Medicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided. If a claim isn't filed within this time limit, Medicare can't pay its share. For example, if you see your doctor on March 22, 2012, the Medicare claim for that visit must be filed no later than March 22, 2013. Check the "Medicare Summary Notice" (MSN) you get in the mail every 3 months, or login to MyMedicare.gov to make sure claims are being filed timely. If the claims aren't being filed timely:
- Contact your doctor or supplier, and ask them to file a claim.
- If they don't file a claim, call 1-800-MEDICARE. Ask for the exact time limit for filing a Medicare claim for the service or supply you got. If it's close to the end of the time limit and your doctor or supplier still hasn't filed the claim, you should file the claim.
How do I file a claim?
Fill out the Patient Request for Medical Payment form (CMS-1490S).You'll find the address for form submission in the instructions. Follow the instructions on the second page to submit the form to your carrier. Get this form in Spanish.
If you don't know the address for your carrier, you can:
If you want someone to be able to call 1-800-MEDICARE on your behalf or you want Medicare to give your personal information to someone other than you, you need to fill out an "Authorization to Disclose Personal Health Information."